Total Hip Replacement

WHAT YOU SHOULD KNOW:

Total hip replacement is surgery to replace a hip joint damaged by wear, injury, or disease. This procedure is also called open hip replacement or total hip arthroplasty (THA). The hip joint is a "ball and socket" joint and is your largest weight-bearing joint. The ball-shaped top of the femur (thigh bone) sits in the acetabulum socket (hollow area) of the pelvic bone. The joint is held together by ligaments and muscles. The socket is lined with cartilage (firm, flexible tissue) that can become damaged or worn away, causing pain. Arthritis, infection, injury, or loss of blood supply to the ball of the femur can damage the joint. You may need to have hip replacement done when you have unrelieved pain or problems with walking.

Your caregiver will make an incision (cut) on the front, side, or back of your hip . During the surgery, the damaged parts of your hip joint are removed and replaced by artificial implants (man-made parts). The implants may be made of metal, ceramic, or plastic material. They are fixed tightly inside your femur and pelvic bones. Once in place, they are joined together just like a ball fitting in a socket. You may need to have one or both of your hip joints replaced. Having this surgery may ease your pain, make your hip joint more stable, and improve movement of your legs.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

Anti-clotting medicines: These medicines are given to help prevent blood clots from forming in your blood vessels. You may need any of the following:

Aspirin to stop blood clots: Aspirin helps thin the blood to keep blood clots from forming. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than directed. This medicine makes it more likely for you to bleed or bruise.

Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:

Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.

Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.

Take this medicine exactly as your caregiver tells you. Tell your caregiver right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your caregiver uses these tests to decide how much medicine is right for you.

Talk to your caregiver about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.

Warfarin: Warfarin is a type of medicine that helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Using warfarin may cause you to bleed or bruise more easily. If you are taking warfarin:

Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.

Many medicines cannot be used when taking warfarin. Talk to your caregiver about all of the other medicines that you use. Tell your dentist and other caregivers that you take warfarin. Wear a bracelet or necklace that says you are taking this medicine.

You will need to have regular blood tests while taking warfarin. Your caregiver uses these tests to decide how much medicine is right for you to take. Take warfarin exactly how your caregiver tells you to. Tell your caregiver right away if you forget to take the medicine, or if you take too much.

Talk to your caregiver about your diet. Warfarin works best when you eat about the same amount of Vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods.

Pain medicines: These groups of medicines are given to decrease your pain after your surgery. You may need any of the following:

Acetaminophen: This medicine is used to decrease pain and lower a high body temperature (fever). Taking too much acetaminophen can hurt your liver. Read labels so that you know the active ingredients in each medicine that you take. Talk to your caregiver before taking more than one medicine that contains acetaminophen. Ask your caregiver before taking over-the-counter medicine if you are also taking pain medicine prescribed (ordered) for you.

NSAIDs: Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.

Pain medicine: You may need medicine to take away or decrease pain.

Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Ask your caregiver when you need to return to have your wound checked, and drain or stitches removed. You may also need to have blood collected for tests.

Ask your caregiver for a wallet card with all the information about your surgery. This may include the date and type of surgery you have had. The card may also have information on what part of your joint was replaced. It will also have information about the artificial implants (man-made parts) that were used. Always bring this card with you during travels and going through security areas.

Activities, exercises, and assistive devices:

Using a cane, walker, or crutches: You may be asked to start walking or moving soon after your surgery. You may need to use a cane, walker, or crutches to assist your walking and balance. This may help you get around, and decrease your chance of falling or being hurt. It is important to use your crutches, cane, or walker correctly. Ask your caregiver for more information about how to choose and use crutches, a cane, or a walker.

Exercises: You may be taught, or have been taught before your surgery, about exercises you should do. These exercises will help strengthen the muscles around your hip joint and speed up your recovery. You may want to apply ice to your hip before doing these exercises to reduce your discomfort.

Preventing dislocation of your hip implant: Your implants are at risk for moving out of place while you are recovering from your surgery. This can happen when you start going back to your normal daily activities. Do the following to help prevent this from happening:

Avoid leaning forward when you are sitting in bed with your legs straight.

Avoid sitting on a low chair. Use armrests when rising from a sitting position to decrease the force and pressure on your hips.

Do not bend forward with your legs crossed. Lift objects with your knees bent rather than straight.

Do not walk too fast and avoid walking on soft floors to prevent pressure on your hips.

Start on low-impact sports when you can bear the discomfort. Low-impact sports may include stationary cycling, dancing, golf, swimming, and walking. Ask your caregiver for more information on what sports or exercises may be right for you. Ask him also when you can get into these sports or exercises.

Helping your wound heal:

Diet: Being overweight or obese may delay wound healing. Eating the right foods may help you lose weight. Eat a variety of healthy foods to give you more energy and help wound heal faster. Healthy foods are fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Ask your caregiver for the right diet to keep you from gaining too much weight.

Smoking: Avoid smoking cigarettes, cigars, or pipes. Smoking can increase your risk of having blood and heart problems. Smoking can also delay wound healing. Ask your caregiver on ways how to quit smoking.

Vitamins: Supplements like vitamin C and E, and minerals like zinc, may help wound heal faster. These supplements can help in the repair of tissues needed in wound healing. They can also increase your immune function to prevent wound infection. Ask your caregiver for more information about other supplements that can help your wound heal.

Other things to keep in mind:

Always keep your knees apart. Place a leg wedge or pillow between your knees when sitting or lying down. When getting into or out of bed, keep your knees apart and the operated-on leg out to the side.

Do not raise or position your knees higher than your hip when sitting.

Use an elevated toilet seat.

Use showers instead of bathtubs when you bathe.

You may need to have antibiotic medicines before certain dental procedures. Tell your dentist that you have a hip replacement.

Preventing blood clots and deep vein thrombosis:

Deep vein thrombosis (DVT) is a condition where blood clots form inside your veins. This can easily happen after having a major bone surgery. Ask your caregiver for more information about deep vein thrombosis. The following can help prevent clots from forming inside your veins:

Activity and exercises: You may be asked to start moving your legs, standing, and walking soon after your surgery. This prevents blood from staying in your legs and causing clots to form inside your veins

Compression stockings: Your caregiver may have you wear compression stockings. These are tight elastic stockings that put pressure on your legs after your surgery. The pressure is highest in the toe and decreases as it goes towards the thighs. Wearing pressure stockings help push blood back up to the heart and keeps clots from forming. Ask your caregiver for more information on using compression stockings.

CONTACT A CAREGIVER IF:

You get a fever.

You have chills, a cough, or feel weak and achy.

You have more pain and swelling in your hip joint, even after taking pain medicines.

Your skin is itchy, swollen, or has a rash.

You are constipated or are having problems with having a bowel movement (BM).

You are having pain or burning with passing urine.

You have questions or concerns about your hip surgery, recovery, or medicine.

SEEK CARE IMMEDIATELY IF:

You have seizures (convulsions), cannot think clearly, or get rashes on your head, neck and chest.

Your bandages become soaked with blood.

Your incision is swollen, red, has pus coming from it, or it has come apart.

You have trouble urinating and are passing little or no urine.

Your leg feels warm, tender, and painful. It may look swollen and red.

You have chest pain or trouble breathing that is getting worse over time.

You suddenly feel lightheaded and have trouble breathing.

You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.